Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 611 prospectively studied patients in a surgical intensive care unit, 177 developed hospital infections (29%): urinary tract infections (37.2%), pneumonia (22.5%), sepsis (19.7%), wound infections (9.6%), etc. The commonest pathogens were Pseud. aeruginosa, E. coli, Staph. aureus, enterococci, Klebsiella pneumoniae and Proteus mirabilis. In preventing and combating hospital infections in intensive care units, priority should be given not to antibiotics but to hygiene in the hospital. Systemic antibiotic prophylaxis prevents neither hospital-contracted pneumonia, sepsis nor urinary tract infections. There is an urgent need for controlled studies on the necessity and selection of locally active antibacterial and antimycotic substances to prevent germ ascension in vein and bladder catheters.
Helv Chir Acta 1978 Dec
PMID:[Antibiotic prophylaxis in intensive care]. 72 86

Partial splenectomy, with resection of the lower one-fourth to one-third spleen, was performed in 10 children with Hodgkin's disease as part of an otherwise standard staging laparotomy. The technique proved to be safe and practical, with no postoperative complications. No evidence to date indicates that splenic involvement was missed, and all the children have thus far continued to do well, with no deaths from either underlying disease or postsplenectomy sepsis. The procedure is undergoing a prospective clinical trial in an effort to determine whether or not it is comparable from a diagnostic point of view to total splenectomy. Available data indicate that the risk of missing intraabdominal disease in a staging laparotomy with a partial splenectomy is quite low. Such a procedure should eliminate the substantial risk of postsplenectomy sepsis in such children.
J Pediatr Surg 1978 Dec
PMID:Partial splenectomy in staging laparotomy for Hodgkin's disease: an alternative approach. 73 56

During a 4-month period 265 women delivered by cesarean section were studied to determine what effect membrane rupture has on the incidence and severity of postoperative infection. There was a definite correlation between the duration of ruptured membranes and the incidence as well as severity of postoperative infections. Only 29% of women with intact membranes subsequently developed endometritis with pelvic cellulitis, in contrast to 85% of those whose membranes were ruptured for less than 6 hours. Wound and pelvic abscesses were encountered in less than 1% of women delivered with intact membranes, yet these complications developed in over 30% of women with membranes ruptured for less than 6 hours. The incidence of septicemia was four times greater in those women whose membranes were ruptured for less than 6 hours. Women with endometritis were treated with one of two empirical antimicrobial regimens chosen randomly. Intravenous penicillin and tetracycline was found to be as effective as, and perhaps slightly more effective than, the combination of intravenous penicillin and intramuscular tobramycin.
Obstet Gynecol 1978 Dec
PMID:Infectious morbidity following cesarean section. Comparison of two treatment regimens. 73 32

A retrospective outcome-oriented audit was conducted to determine the complications associated with percutaneous infraclavicular subclavian catheters in a university hospital. The study is unique since patients having these catheters were not under the care of a select group of physicians and the patients were not restricted to a special nursing unit. One hundred and seventeen catheters were placed in 68 patients. Seventeen types of complications were audited. There were 13 complications (11%) identified as follows: pneumothorax, seven; subcutaneous emphysema, one; subclavian artery hematoma, one; pleural effusion, one; improper position, two; and sepsis, one. No mortality was associated with catheter placement. Pattern analysis suggested physician inexperience as an important cause of complications. The difficulties of establishing a retrospective audit based on documentation errors and omissions are discussed.
Arch Surg 1978 Dec
PMID:Indications, management, and complications of percutaneous subclavian catheters. An audit. 73 74

Twenty infants and young children with hereditary fructose intolerance (HFI) were admitted to hospital. None was diagnosed at admission. Referals were for vomiting of unknown aetiology (16X), pyloric stenosis or hiatus hernia (5X), toxic condition (3X), and hepatomegaly of unknown origin (5X). Feeding difficulties (20X), vomiting (18X), and failure to thrive (16X) were leading symptoms. The most frequent clinical findings were hepatomegaly (18X), pallor (14X), haemorrhages (13X). Ascites, oliguria, tachypnoea, fever, splenomegaly and rickets were less frequent. Laboratory findings were indicative of disturbed hepatic and renal tubular function and also of disturbed intermediary metabolism (hypokaliaemia, hypophosphataemia). However, hypoglycaemia was found in only 4 out of 15 patients tested. Differential diagnosis after hospital admission centered on metabolic disorders such as glycogenoses, galactosaemia, tyrosinosis, or Wilson's disease. Hepatitis, toxic hepatosis, liver tumour, intrauterine infection and sepsis were also considered. Eleven children had first ingested fructose within the first 6 weeks of life. The diagnosis was usually established only many weeks or months after first fructose intake and appearance of symptoms. This documents how difficult the diagnosis of this disease can be both in practice and in hospital. The course was severe in 11 children and lethal in 4. In only 5 patients was the course mild. The 16 survivors are doing well under fructose-exclusion diet. Irreversible visual impairment after intraocular haemorrhage occurred once. In each case HFI could have been suspected immediately, had a detailed nutritional history been taken. Practising paediatricians should know the composition of commonly used infant formulae. They should never prescribe sugared condensed milk for intractable vomiting prior to excluding HFI. Solution for intravenous infusion containing fructose and sorbitol are life-threatening for undiagnosed HFI patients.
Helv Paediatr Acta 1978 Dec
PMID:Hereditary fructose intolerance in early childhood: a major diagnostic challenge. Survey of 20 symptomatic cases. 73

Urinary tract obstruction and vesicoureteral reflux, which are often associated with urinary tract infections, may lead to progressive renal damage. Relatively little is known about the pathophysiology of this process, and a need exists for noninvasive methods of its detection in its early stages. Because urine is refluxed into the venous and lymphatic drainage of the kidney in severe vesicoureteral reflux and urinary tract obstruction, an immune response to urinary tract components might play a role in the pathophysiology of progressive renal damage and serve as a serologic marker for its presence. A solid-phase radioimmunoassay for a protein found only in the urine (Tamm-Horsfall protein [THP]) was developed and used to measure antibody to THP in the serum of 60 subjects. Significant elevations of antibody to THP were observed in five of 15 patients with obstruction and infection of the urinary tract and in one of 10 patients with infection alone, when these patients were compared with 12 healthy control subjects. Similar elevations of antibody to THP were not seen in uninfected patients with urinary tract obstruction or in patients with low-grade vesicoureteral reflux or sepsis of nonrenal origin. These results suggest that the measurement of antibody to THP might be useful in the identification of patients with obstruction and infection of the urinary tract.
J Infect Dis 1978 Dec
PMID:Antibody to Tamm-Horsfall protein in patients with urinary tract obstruction and vesicoureteral reflux. 73 57

All the 22359 deliveries in 1971-1974 at the Institute of Midwifery, Helsinki, were analyzed for risk factors. 1196 infants (5.35%) had one or more risk factor at birth, the most common being an Apgar score of 6 or less at 5 or 15 minutes, hyperbilirubinaemia, and a birth weight of 2000 g or below. The other risk factors registered were neurological symptoms, respiratory difficulties, hypoglycaemia, newborn infants of diabetic mothers and cases with sepsis. 124 infants in the risk group died during the first week. This was 83% of the total neonatal mortality. Except for hyperbilirubinaemia, which was less frequent in 1974, there was no marked change in the composition of the risk group from 1971 to 1974.
Ann Clin Res 1978 Dec
PMID:Occurrence of risk factors in newborn infants. A study of 22359 consecutive cases. 74 34

Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections (5), gram-negative bacterial meningitis (2), septic arthritis (1), epidural abscess (1) and isolated septicemia (1). The antibacterial spectrum of cefoxitin was found to be one which included all gram-positive organisms except enterococci, most gram-negative organisms except Pseudomonas aeruginosa, and almost all of the important anaerobic organisms. The only five treatment failures included one patient with empyema and one with septic arthritis, both caused by Serratia marcescens, initially only moderately susceptible to cefoxitin, which subsequently developed increased resistance, two patients with contaminated intravenous catheters, and one patient with epidural abscess and cerebritis, who was treated late in the course. There was one serious clinical superinfection with P. aeruginosa. The drug levels noted in the pus and joint fluid were half to two-thirds of the simultaneous serum level. In inflamed meninges, up to 30% of the serum level was noted in the cerebrospinal fluid, and as the process resolved, 10 to 15% was noted. Toxicity of cefoxitin was mild and constituted skin rash in three patients (7%) and phlebitis in eight (19%).
Antimicrob Agents Chemother 1978 Dec
PMID:Use of cefoxitin, new cephalosporin-like antibiotic, in the treatment of aerobic and anaerobic infections. 74 74

One hundred patients with term pregnancy, were studied. There were placed in two groups of 50 each; one was the problem group with antecedents and confirmation of premature rupture of membranes; and the other group with intact amnios at the time of delivery, which served as controls. Clinical history, leukocyte count, temperature determination on admission and during trans-partum, leukocyte count in mixed blood from the umbilical cord and clinical surveillance were carried out, until 96 hours after delivery, of mother and child looking for sepsis signs. In the problem group there were 10 cases of maternal infection and 12 of newborns. There were no infections in the control group. There was no perinatal mortality. The most useful examination as to maternal and neonatal infection, was leukocytic count on admission, followed by trans-partum count and maternal temperature. Fetal leukocytic count above 12,500 per mm3 was useful in 70% of the newborns with complications.
Ginecol Obstet Mex 1978 Dec
PMID:[Clinical observation in the premature rupture of membranes. Early detection of maternofetal infections]. 74 93

Right ventriculotomy with extracorporeal circulation was used for removal of an infected transvenous pacemaker electrode which was firmly attached to the myocardium in a patient with septicemia. Alternative methods and suggestions to prohibit electrode incarceration are discussed.
Thoraxchir Vask Chir 1978 Dec
PMID:[Septicemia secondary to an infected pacemaker system: removal of the endocardial lead with the aid of extracorporeal circulation (author's transl)]. 75 Dec 79


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